Virginia implemented a Medicaid home and community-based waiver demonstration program in 2007 to transition children with psychiatric diagnoses from residential to community-based care. As the independent evaluator for the CMH Program, Optimal will conduct a five-year evaluation of the outcomes and fidelity of the program. Optimal will implement a quasi-experimental study design to measure the functional levels for children enrolled in the CMH program and children in a comparison group who are not enrolled in the program. In addition, Optimal will evaluate whether the program was implemented as intended.